Abstract
Transcatheter intravascular electrocoagulation for therapeutic occlusion of vessels has been experimentally developed and successfully used clinically as an alternative to, and in conjunction with, more routine methods of vessel occlusion. A constant current power source and a steelguide wire anode are used for the occlusion. The subject is grounded with a standard bovie plate insulated from the skin by a highly lubricated sponge. Permanent occlusion of strategic vessels at accurately controlled sites has been achieved with little risk of embolization of non-target areas. There has been minimal damage to vessel walls, and complete occlusion has been possible despite heparinization and/or thrombocytopenia. One limitation is the inconstant ability to position the anode precisely at the desired site of occlusion. Also, a long time may be required (up to one hour) to occlude larger vessels with presently available anodes. Wider use must await refinements in development of the anode material and in its delivery system.
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Araki, C., Handa, H., Yoshida, K.: Electrically induced thrombosis for the treatment of intracranial aneurysms and angiomas. Excerpta Medica International Congress Series 110:651–654, 1965
Athanasoulis, C.A., Baum, S., Waltman, A.A., Ring, E.J., Imbembo, A., Vander Salm, T.J.: Control of acute gastric mucosal hemorrhage. N. Engl. J. Med. 290:597–603, 1974
Baker, R., Hirschfeld, B., Pizzo, S., Thompson, W.M.: The effect of increasing current for transcatheter electrocoagulation (TCEC). Invest. Radiol. (in press)
Bookstein, J.J., Chlosta, E.M., Foley, D., Walter, J.F.: Transcatheter hemostasis of gastrointestinal bleeding using modified autogenous clot. Radiology 113:277–285, 1974
Bookstein, J.J., Goldstein, H.M.: Successful management of postbiopsy arteriovenous fistula with selective arterial embolization. Radiology 109:535–536, 1973
Carey, L.S., Grace, D.M.: The brisk bleed: Control by arterial catheterization and Gelfoam plug. J. Can. Assoc. Radiol. 25:113–115, 1974
Diulzio, V., Curri, G., Capestro, F., Boccanelli, A., Renzi, R.: Electrolytic phenomena and massive gas generation around pacemaker electrodes. Eur. J. Cardiol. 3:297, 1975
Dymond, A.M.: Characteristics of the metal tissue interfaced of stimulation electrodes. IEEE Trans. Biomed. Eng. 23:274–280, 1976
Eisenberg, H., Steer, J.L.: The nonoperative treatment of massive pyloroduodenal hemorrhage by retracted autologous clot embolization. Surgery 79:414–421, 1976
Gold, R.E., Blair, D.C., Finlay, J.D., Johnston, D.W.B.: Transarterial electrocoagulation therapy of a pseudoaneurysm in the head of the pancreas. Am. J. Roentgenol. 125:422–426, 1975
Goldman, M.L., Freeny, P.C., Tallman, J.M., Galambos, J.T., Bradley, E.L., Salom, A., Oen, K.-T., Gordon, I.J., Mennemeyer, R.: Transcatheter vascular occlusion therapy with isobutyl 2-cyanoacrylate (Bucrylate) for control of massive upper gastrointestinal bleeding. Radiology 129:41–49, 1978
Goldstein, H.M., Wallace, S., Anderson, J.H., Bree, R.L., Gianturco, C.: Transcatheter occlusion of abdominal tumors. Radiology 120:539–545, 1976
Gomes, A.S., Rysauy, J.A., Spadaccini, C.A., Probst, P., D'Souza, V., Amplatz, K.: The use of the bristle brush for transcatheter embolization. Radiology 129:345–350, 1978
Greatbatch, W., Piersma, B., Shannon, F.D., Calhoon, S.W.: Polarization phenomena relating to physiological electrodes. Advances in cardiac pacemakers. Ann. N.Y. Acad. Sci. 167:722–744, 1969
Hirschfeld, B.J., Clark, H.C., Thompson, W.M.: The effect of temperature and pH in transcatheter electrocoagulation (TCEC). Invest. Radiol. (in press)
Hirschfeld, B., McAlister, D.S., Lowther, D., Jackson, D.C., Pizzo, S., Thompson, W.M.: An evaluation of size and position of the anode and cathode during transcatheter electrocoagulation (TCEC). Invest. Radiol. 14:387, 1979
Hosobuchi, Y.: Electrothrombosis of carotid-cavernous fistula. J. Neurosurg. 42:76–85, 1975
Leeming, M.N., Ray, C., Jr., Howland, W.S.: Low voltage, direct current burns. JAMA 214:1681–1684, 1970
Loucks, R.B., Weinberg, H., Smith, M.: The erosion of electrodes by small currents. Electroencephalogr. Clin. Neurophysiol. 11:823, 1959
McAlister, D.S., Johnsrude, I.S., Miller, M.D., Clapp, J., Thompson, W.M.: Occlusion of an acquired renal arteriovenous fistula with transcatheter electrocoagulation: A case report. Am. J. Roentgenol. 132:998–1000, 1979
Miller, F.J., Rankin, R.S., Gliedman, J.B.: Experimental internal iliac artery embolization: Evaluation of low viscosity silicone rubber isobutyl 2-cyanoacrylate, and carbon microspheres. Radiology 129:51–58, 1978
Miller, M.D., Johnsrude, I.S., Limberakis, A.J., Jackson, B.C., Pizzo, S., Thompson, W.M.: Clinical use of transcatheter electrocoagulation. Radiology 129:211–214, 1978
Mullan, S.: Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas. J. Neurosurg. 41:657–670, 1974
Phillips, J.F.: Transcatheter electrocoagulation of blood vessels. Invest. Radiol. 8:295–304, 1973
Phillips, J.F., Robinson, A.E., Johnsrude, I.S., Jackson, D.C.: Experimental closure of arteriovenous fistulae by transcatheter electrocoagulation. Radiology 115:319–321, 1975
Rösch, J., Dotter, C.T., Brown, M.J.: Selective arterial embolization. A new method for control of acute gastrointestinal bleeding. Radiology 102:202–206, 1972
Rowley, B.A.: Electrolysis—a factor in cardiac pacemaker electrode failure. IEEE Trans. Biomed Electr. 10:176, 1963
Sawyer, P.N., Pate, J.W.: Bio-electrical phenomena as an etiologic factor in intravascular thrombosis. Am. J. Physiol. 175:103–107, 1973
Serbienko, F.A.: Balloon catheterization and occlusion of major cerebral vessels. J. Neurosurg 41:125–145, 1974
Tadavarthy, S.M., Moller, J.H., Amplatz, K.: Polyvinyl alcohol (Ivalon): A new embolic material. Am. J. Roentgenol. 125:609–616, 1975
Thompson, W.M., Pizzo, S.V., Jackson, D.C., Johnsrude, I.S.: Transcatheter electrocoagulation: A therapeutic angiographic technique for vessel occlusion. Invest. Radiol. 12:146–153, 1977
Thompson, W.M., Pizzo, S., Jackson, D.C., Johnsrude, I.S.: The effect of drug induced thrombocytopenia on direct current transcatheter electrocoagulation. Radiology 124:831–833, 1977
Thompson, W.M., McAlister, S., Miller, M., Pizzo, S.V., Jackson, D.C., Johnsrude, I.S.: Transcatheter electrocoagulation: An experimental evaluation of the anode. Invest Radiol. 14:41–47, 1979
Thompson, W.M., Johnsrude, I.S., Jackson, D.C., McAlister, S., Miller, M.D., Pizzo, S.V.: Vessel occlusion with transcatheter electroagulation: An initial clinical experience. Radiology 133:335–340, 1979
Wallace, S., Gianturco, C., Anderson, J.H., Goldstein, H.M., Davis, L.J., Bree, R.L.: Therapeutic vascular occlusion utilizing steel coil technique: Clinical applications. Am. J. Roentgenol. 127:381–387, 1976
White, R.I., Kaufmann, S.L., Barth, K.H., DeCaprio, V., Strandberg, J.D.: Embolotherapy with detachable silicone balloons: Technique and clinical results. Radiology 131:619–627, 1979
Yoneda, S., Matsuda, M., Shimizu, Y., Goto, H., Handa, H., Ogawa, Y.: Electrothrombosis of arteriovenous malformation. Neurol. Med. Chir. 17:19–28, 1977
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Thompson, W.M., Johnsrude, I.S. Vessel occlusion with transcatheter electrocoagulation. Cardiovasc Intervent Radiol 3, 244–253 (1980). https://doi.org/10.1007/BF02552734
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DOI: https://doi.org/10.1007/BF02552734